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FORM 16 Certificate No.

: 593
[See Rule 31(1) (a)]
PART A
Certificate under section 203 of the Income-tax Act, 1961 for tax deducted at source on Salary
Name and address of the Employer Name and address of the Employee
XAVIENT SOFTWARE SOLUTIONS INDIA PRIVATE LIMITED ABDUL QADIR KIDWAI
54,
SDF D-05, E-10,15,21 & 24
N.S.E.Z., PHASE-II NOIDA 201305

PAN of the Deductor TAN of the Deductor PAN of the Employee Employee Reference No.

AAACX0465F MRTX00005F CCOPK6147G XIND13517

CIT (TDS) Assessment year Period with the Employer

Address CIT SEC-20, NOIDA (U.P.)


From To
2018-19
01-Apr-2017 31-Mar-2018

Summary of amount paid/credited and tax deducted at source thereon in respect of the employee
Receipt Numbers of original quarterly Amount of tax
Amount Amount of tax
Quarter statements of TDS under sub-section (3) of deposited/remitted
paid/credited deducted ( Rs. )
section 200. (Rs. )
1 QSOKFDHD 0 0
2 QSQOUVYD 0 0
418,826
3 QSVSQCYD 0 0
4 QSZGIVCF 0 0
Total 418,826 0 0
II. DETAILS OF TAX DEDUCTED AND DEPOSITED IN THE CENTRAL GOVERNMENT ACCOUNT THROUGH CHALLAN
(The deductor to provide payment wise details of tax deducted and deposited with respect to the deductree)

Challan indentification number ( CIN )


Tax deposited in respect
SI. No. Status of
of the deductee (Rs.) BSR Code of Bank Date on which tax deposited Challan Serial
matching with
Branch (dd/mm/yyyy) Number
OLTAS
Totals

Verification
I Ashish Jain, son of Mr. O.P. Jain working in the capacity of Director-Finance & Accounts do hereby certify that a sum of Rs.0 [Rupees NIL] has
been deducted and deposited to the credit of the Central Government. I further certify that the information given above is true, complete and
correct and is based on the books of account, documents, TDS statements, TDS deposited and other available records.

Digitally Signed By ASHISH JAIN


Signature of the person responsible for deduction of tax
Place: NOIDA Full Name: Ashish Jain
Date: 04-Jun-2018 Designation: Director-Finance & Accounts

Signature Not Verified


Digitally signed by: ASHISH JAIN
Date: 2018.06.06 18.51.14
Reason:
Location: NOIDA
XIND13517 ABDUL QADIR KIDWAI CCOPK6147G Certificate No.: 593

PART B
DETAILS OF SALARY PAID AND ANY OTHER INCOME AND TAX DEDUCTED
1. Gross Salary (Rs.) (Rs.) (Rs.) (Rs.)
a. Salary as per provisions contained in section 17(1) 418,826
b. Value of perquisites under section 17(2) (as per Form No. 0
12BA, wherever applicable)
c. Profits in lieu of salary under section 17(3) (as per Form 0
No.12BA, wherever applicable)
d. Total 418,826
2. Less: Allowance to the extent exempt under section 10
House Rent Allowance 81,170
Conveyance Allowance 19,200
Medical Reimbusement 9,403
Total 109,773
3. Balance (1 - 2) 309,053
4. Deductions

5. Aggregate of 4 0
6. Income chargeable under the head 'salaries' (3 - 5) 309,053
7. Add: Any other income reported by the employee
Total of above 0
8. Gross total income (6 + 7) 309,053
9. Deductions under Chapter VI-A Qualifying Deductible
Gross Amount
(A) Section 80C, 80CCC and 80CCD Amount Amount
(a) Section 80 C
a. Life Ins. Prem/Infra Bond/ULIP 10,412 10,412
Total of Section 80C, 80CCC and 80CCD 10,412 10,412 10,412

(B) Other Sections under Chapter VI-A


a. Section 80 D (Parents) 7,038 7,038
b. Section 80 D(others) 5,388 5,388
c. Section 80 E 16,696 16,696
Total of Other Sections under Chapter VI-A 29,122 29,122 29122
10. Aggregate of deductible amount under Chapter VI-A 39,534
11. Total Income (8 - 10) 269,520
12. Tax on total income 0
13. Education cess (on tax computed at S.No.12) 0
14. Tax payable (12+13) 0
15. Less: Relief under section 89 (attach details) 0
16. Tax payable (14-15) 0

Verification
I, Ashish Jain, son of Mr. O.P. Jain working in the capacity of Director-Finance & Accounts do hereby certify that the information given above is
true, complete and correct and is based on the books of account, documents, TDS statements, and other available records.

Digitally Signed By ASHISH JAIN


Signature of the person responsible for deduction of tax
Place: NOIDA Full Name: Ashish Jain
Date: 04-Jun-2018 Designation: Director-Finance & Accounts

Signature Not Verified


Digitally signed by: ASHISH JAIN
Date: 2018.06.06 18.51.14
Reason:
Location: NOIDA
ABDUL QADIR KIDWAI Annexure to Form No. 16 Certificate No.: 593

1. Gross Salary Total(Rs.)


Basic 182,400
House Rent Allowance 102,135
Conveyance Allowance 19,200
Special Allowance 43,947
Medical Reimbursement 9,403
Leave Travel Assistance 11,385
Medical Taxable 5,597
Bonus 16,800
Arrears-HRA 2,435
Arrears-Spcl Allow 4,883
Shift Allowance 4,800
Comp Off Pay out 15,841
Gross Salary 418,826
HRA Exemption Calculation
Period Basic Rent Paid HRA Recd Rent Paid Less 40/50% Salary Least of
Non Metro Metro (A) 10% Salary (B) (C) (A,B,C)

Apr-2017 15,200 0 8,300 6,685 6,780 7,600 6,685


May-2017 15,200 0 8,300 6,685 6,780 7,600 6,685
Jun-2017 15,200 0 8,300 9,120 6,780 7,600 6,780
Jul-2017 15,200 0 8,300 9,120 6,780 7,600 6,780
Aug-2017 15,200 0 8,300 9,120 6,780 7,600 6,780
Sep-2017 15,200 0 8,300 9,120 6,780 7,600 6,780
Oct-2017 15,200 0 8,300 9,120 6,780 7,600 6,780
Nov-2017 15,200 0 8,300 9,120 6,780 7,600 6,780
Dec-2017 15,200 0 8,300 9,120 6,780 7,600 6,780
Jan-2018 15,200 0 8,300 9,120 6,780 7,600 6,780
Feb-2018 15,200 0 8,300 9,120 6,780 7,600 6,780
Mar-2018 15,200 0 8,300 9,120 6,780 7,600 6,780
Totals: 182,400 99,600 104,570 81,360 91,200 81,170

Signature Not Verified


Digitally signed by: ASHISH JAIN
Date: 2018.06.06 18.51.14
Reason:
Location: NOIDA
FORM NO. 12BA Certificate No.: 593
[{See Rule 26A(2)(b)}]
Statement showing particulars of perquisites, other fringe benefits or amenities and profits in lieu of salary with value thereof
1. Name and address of employer : XAVIENT SOFTWARE SOLUTIONS INDIA PRIVATE LIMITED
54,
SDF D-05, E-10,15,21 & 24
N.S.E.Z., PHASE-II NOIDA 201305
2. TAN MRTX00005F
3. TDS Assessment Range of employer: CIT SEC-20, NOIDA (U.P.)

4. Name,designation and ABDUL QADIR KIDWAI - SOFTWARE TEST ENGINEER


PAN of employee: CCOPK6147G
5. Is the employee a director or a person with substantial interest NO
in the company (where the employer is a company):
6. Income under the head 'Salaries' of the employee: 418,826
(other than from perquisites)
7. Financial Year 2017-18
8. Valuation of Perquisites
Amount, if any,
Value of perquisite Amount of perquisite
S.No. Nature of perquisites (see rule 3) recovered from the
as per rules chargeable to tax
employee
(Rs.) (Rs.) (Rs.)
1 Total value of perquisites 0 0 0
2 Total value of profits in lieu of salary as per section 17(3) 0 0 0

9. Details of tax:
(a) Tax deducted from salary of the employee under section 192(1) 0
(b) Tax paid by employer on behalf of the employee under section 192(1A) 0
(c) Total tax paid 0
(d) Date of payment into Government treasury as per Form-16
DECLARATION BY EMPLOYER
I, Ashish Jain, son of Mr. O.P. Jain working as Director-Finance & Accounts do hereby declare on behalf of XAVIENT SOFTWARE SOLUTIONS
INDIA PRIVATE LIMITED that the information given above is based on the books of account, documents and other relevant records or
information available with us and the details of value of each such perquisite are in accordance with section 17 and rules framed thereunder and
that such information is true and correct.

Digitally Signed By ASHISH JAIN


Signature of the person responsible for deduction of tax
Place: NOIDA Full Name: Ashish Jain
Date: 04-Jun-2018 Designation: Director-Finance & Accounts

Signature Not Verified


Digitally signed by: ASHISH JAIN
Date: 2018.06.06 18.51.14
Reason:
Location: NOIDA